Primary Aims:
1.1 To compare the event-free survival (EFS) of patients with IR RMS treated with surgery, radiotherapy, and VAC alternating with VI (VAC/VI) to that of patients treated with surgery, radiotherapy and VAC/VI plus temsirolimus (TORI).

Secondary Aims:
1.2 To compare the overall survival (OS) of patients with IR RMS treated with surgery, radiotherapy, and VAC alternating with VI to that of patients treated with surgery, radiotherapy and VAC/VI plus TORI.

Exploratory Aims:
1.3.1 To compare the outcome of patients based on their FOXO1 fusion gene partner, by evaluation PAX3 vs. PAX7 in all patients found to be FOXO1 fusion positive.

1.3.2 To compare the outcome of patients based on their [F18]-fluorodeoxy-D-glucose-positron emission tomography (FDG-PET) response at Week 9 (positive or negative), as assessed by Deauville Criteria (5-point).

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